The US is experiencing a brutal opioid epidemic. In 2015, 33,000 Americans died from overdoses involving prescription painkillers, heroin, and synthetic opioids, according to the National Institutes of Health. Many opioid overdoses can be reversed with timely medical treatment, however—someday, you may be in a position to save a life. This brief guide shows you how.

The illicit use of heroin and prescription painkillers is rare among college students. Yet this epidemic is affecting demographics that were previously considered relatively immune to drug crises. “My freshman year of college, my older sister went to rehab for heroin addiction. People from all ethnicities and social classes are struggling with opioid addiction,” says a third-year undergraduate at Saint Louis University, Missouri.

In this article, “opioid” covers heroin, prescription painkillers, and synthetic opioids sold on the street. For info on getting help with abuse and addiction, see Get help or find out more.

What to do if someone may have overdosed: Call 911 immediately

Act quickly: Most deaths occur one to three hours after the overdose, so you have a window for intervention.

Get medical help: When people survive an overdose, it is because professional help was available. You do not need to be sure the person has overdosed on opioids (or any other substance) before calling 911. Calling 911 usually ensures quicker medical help than taking the victim to the hospital yourself.

Tell the 911 dispatcher: Let them know if the person’s breathing has slowed or stopped and if they are unresponsive. Give the dispatcher the exact location.

Be aware of Good Samaritan laws: In most states, people who seek help with a suspected overdose are immune from drug-related criminal charges under Good Samaritan laws (also known as 911 Immunity Laws). Your college may have similar policies (sometimes called medical amnesty). For information about your state, see Get help or find out more.

What does an opioid overdose look like?

» The signs of opioid overdose include:

Small pupils

Droopy arms and legs, and the inability to stand or walk

Itching

Slurred speech

Shallow and uneven breathing

Being unresponsive

Loss of consciousness

» As the window for intervening narrows, signs include:

Pale face

Blue lips

Gurgling chest sounds

Could I be at risk for opioid abuse?

Opioid addiction is difficult to treat. Avoiding illicit drug use is the safest strategy. Here’s how to look out for yourself:

If you are using a prescription opioid medication that was not prescribed to you, seek help.

If you are using an opioid medication prescribed to you, be self-aware about your reasons: Opioid medications are prescribed for long-term pain associated with various medical issues or for short-term pain control after surgery or an injury. If you are using opioids for other reasons—e.g., to get high or buzzed—seek help.

If you are using opioids for pain relief, and your pain is becoming more difficult to control, discuss that with your physician immediately.

If you have a family history of drug abuse/addiction and need medication for short-term pain, consider asking your physician for a pain medication other than opioids. Having a family history of drug abuse/addiction puts you at a higher risk for abuse/addiction.

If you are abusing opioids or may be addicted, you will need support with your recovery. See Get help or find out more (below).

Where can I get help with opioid abuse or addiction?

Ask your physician or other health care provider for a referral to an addiction specialist.

If you have health insurance, check the insurance company website for addiction specialists covered by your plan.

Ask at your student health center, counseling center, place of worship, or community center about addiction assistance.

Call your local hospital for help finding medical professionals with addiction expertise.

Look at community directories or online for a specialist in your area: Make sure the person is licensed or certified in mental or behavioral health, or is a licensed counselor in social work or professional counseling.

Try Narcotics Anonymous for local, free, anonymous support groups.

Many detox centers offer free initial consultations.

For more key info and resources, see Get help or find out more (below).

What are the options for accessing reversal treatment?

Many opioid overdoses can be reversed with treatment. The opioid reversal medications naloxone and naltrexone can be delivered via a nasal spray, by injection, or intravenously. These reversal drugs (or antidotes) are also known by various brand names (e.g., Narcan®).

In most states, via some trained laypeople (not medical professionals) who may have a history of opioid abuse or family members who are abusing opioids

Some states allow pharmacies to dispense naloxone to people meeting certain criteria without a physician’s direct involvement (this is often reported as over-the-counter availability, although that term is technically incorrect)

What exactly does “unresponsive” mean?

Here’s what being unresponsive looks like, according to the Harm Reduction Coalition:

Not answering to their name

Not responding to information they may not want to hear (e.g., “I’m going to call 911”)

Not responding to physical stimulation (e.g., rubbing your knuckles into their sternum, the place in the middle of their chest where the ribs meet, or pinching their earlobes)

If the person wakes up but their breathing seems shallow or their chest feels tight, call 911 anyway

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Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51).

Senate Caucus on International Narcotics Control Substance Abuse and Mental Health Services Administration. Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. 13-4795. Rockville, MD: SAMHSA, 2013.

Jennifer G. Schnellmann, PhD, is an associate professor of pharmacology in the College of Medicine at the University of Arizona, where she teaches toxicology and pharmacology. She is the author of seven books, on topics including cardiovascular pharmacology and strategies for gaining admission to professional school. Jennifer lives in Tucson with her daughter Mary Rose and her husband, Rick.

Lucy Berrington is a health writer, editor, and communications manager. Her work has been published in numerous publications in the US and UK. She has an MS in health communication from Tufts University School of Medicine, Massachusetts, and a BA from the University of Oxford, UK.